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November 3, 2025 Idris Geyre, Authorized Agent Companion Home & Community Services LLC 175 Jackson Avenue N, Suite 262 Hopkins, Minnesota 55343-4565 License Number: 1111028 (245D – HCBS) CORRECTION ORDER Dear Idris Geyre: On October 8, 2025, a licensing review of Companion Home & Community Services LLC, located at 175 Jackson Avenue N, Hopkins, Minnesota, was conducted to determine compliance with state and federal laws and rules governing the provision of home and community-based services to persons with disabilities and age 65 and older under Minnesota Statutes, Chapter 245D. As a result of this licensing review a Correction Order is being issued. A. Reason for Correction Order Pursuant to Minnesota Statutes, section 245A.06, if the Commissioner of the Department of Human Services (DHS) finds that the license holder has failed to comply with an applicable law or rule and this failure does not imminently endanger the health, safety, or rights of the persons served by the program, the Commissioner may issue a Correction Order to the license holder. The following violation(s) of state or federal laws and rules were determined as a result of the licensing review. Corrective action for each violation is required by Minnesota Statutes, section 245A.06 and is hereby ordered by the Commissioner of Human Services. 1. Citation: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (a). Violation: The license holder did not review the ongoing written program abuse prevention plan (PAPP) as required. The license holder did not review the PAPP using the assessment factors in the plan annually in 2025. The PAPP was last reviewed in April 2024. Corrective Action Ordered: Within 30 days of receiving this order, you must review the PAPP using the assessment factors in the plan and revise the plan, if necessary, to reflect the review results. On an ongoing basis, you must maintain compliance as required in this subdivision. 2. Citation: Minnesota Statutes, section 245A.65, subdivision 2, paragraph (b). Violation: For three of seven persons whose record was reviewed (P2, P4, and P6), the license holder did not develop an individual abuse prevention plan (IAPP) as required. Minnesota Statutes, section 245A.02, subdivision 2b defines “annual” or “annually” to mean prior to or within the same month of the subsequent calendar year. a. The license holder did not review and evaluate P2’s IAPP annually in 2025. The license holder reviewed P2’s IAPP in April 2024 and May 2025. b. The license holder developed an IAPP for P4 that identified P4 was vulnerable to self-abuse and was unable to “handle verbal and physical abusive people”. The license holder did not include in P4’s IAPP, statements of the specific measures to be taken to minimize the risk of abuse to P4 and other vulnerable adults and the specific actions the program would take to minimize the risk of abuse to P4 within the scope of licensed services. c. The license holder developed an IAPP for P6 that identified P6 was vulnerable to self-abuse. The license holder did not include in P6’s IAPP, statements of the specific measures to be taken to minimize the risk of abuse to P6 and other vulnerable adults and the specific actions the program would take to minimize the risk of abuse to P6 within the scope of licensed services. Corrective Action Ordered: Within 30 days of receiving this order, you must: · review and revise the IAPP for P4 and P6 to include the specific measures to be taken to minimize the risk of abuse to P4, P6, and other vulnerable adults and the specific action you will take to minimize the risk of abuse within the scope of licensed services; · review the updated IAPP with P4, P6, P4’s case manager, and P6’s case manager; and · provide training to all staff that work with P4 and P6 on the updated IAPP and maintain documentation of this training in the personnel record including the date the training is completed, the number of hours per subject area, and the name of the trainer or instructor. On an ongoing basis, you must maintain compliance as required in this subdivision. 3. Citation: Minnesota Statutes, section 245D.04, subdivision 1. Violation: For one person whose record was reviewed (P4), the license holder did not provide written notice of service recipient rights as required. Minnesota Statutes, section 245A.02, subdivision 2b defines “annual” or “annually” to mean prior to or within the same month of the subsequent calendar year. a. The license holder did not provide P2 with a written notice that identified the service recipient rights and an explanation of those rights annually in 2025. The license holder provided P2 with a written notice of the service recipient rights in April 2024 and May 2025. b. The license holder initiated services with P4 on June 30, 2024. The license holder did not provide P4 with a written notice that identified the service recipient rights and an explanation of those rights within five days of service initiation. The license holder provided P4 with a written notice of the service recipient rights in September 2025. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 4. Citation: Minnesota Statutes, section 245D.05, subdivision 1. Violation: For one person whose record was reviewed (P4), the license holder did not document health needs as required. The license holder did not maintain documentation on how P4’s health needs would be met, including a description of the procedures to be followed to assist with or coordinate medical, dental, and other health service appointments. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 5. Citation: Minnesota Statutes, section 245D.06, subdivision 1. Violation: For one person whose record was reviewed (P4), the license holder did not respond to, and report incidents as required. The license holder maintained documentation that an incident occurred in July 2025 involving P4 that resulted in a serious injury. The license holder did not report this incident and serious injury to P4’s case manager, the Department of Human Services Licensing Division and the Office of the Ombudsman for Mental Health and Developmental Disabilities. Corrective Action Ordered: Within 30 days of receiving this order, you must: · notify P4’s case manager of the serious injury and maintain documentation of this notification in the service recipient record; · notify the Department of Human Services Licensing Division and the Office of the Ombudsman for Mental Health and Developmental Disabilities of the serious injury and maintain documentation of this notification in your program records; and · submit to your licensor a corrective action plan on how you will ensure incidents, including serious injuries, behavioral interventions, and deaths will be reported to legal representatives, case managers, the Department of Human Services and the Ombudsman as required. On an ongoing basis, you must maintain compliance as required in this subdivision. 6. Citation: Minnesota Statutes, section 245D.07, subdivision 1. Violation: For two persons whose records were reviewed (P3 and P5), the license holder did not provide services in compliance with the requirements of this chapter and in accordance with the federal waiver plan as required. a. The license holder provided crisis respite services to P3. The license holder did not fulfill the following requirements for crisis respite, as outlined in the Community Based Services Manual (CBSM): · perform an assessment of P3 and the situation to determine the factors that caused the crisis; and · develop a medical or behavioral intervention plan, in coordination with P3 and P3’s support team. b. According to the Community Based Services Manual (CBSM), parents of minors cannot be paid to provide waiver services. The license holder did not provide services in accordance with the federal waiver plan when they paid the parent of P5 to provide individualized home supports without training services and respite services to P5. Corrective Action Ordered: Within 30 days of receiving this order, you must: · complete the assessment and plan outlined above in (a) for P3; · audit all service recipient records for individuals receiving crisis respite to ensure the requirements outlined in (a) have been completed; and · complete the requirements outlined in (a) for any individuals identified in the audit to be missing the required information. On an ongoing basis, you must maintain compliance as required in this subdivision. 7. Citation: Minnesota Statutes, section 245D.07, subdivision 2. Violation: For three persons whose records were reviewed (P1, P2, and P5), the license holder did not complete initial basic service planning as required. a. The license holder did not review, and revise as needed the preliminary support plan addendum for P1 within 60 days of service initiation to document the services that would be provided, including how and when services would be provided. b. The license holder did not review, and revise as needed the preliminary support plan addendum for P2 within 60 calendar days of service initiation. The license holder developed a preliminary support plan for P2 in April 2024 and reviewed the support plan in May 2025. c. The license holder did not complete a preliminary support plan addendum based on the support plan within 15 days of service initiation. The license holder initiated services for P5 on October 9, 2024 and developed a support plan addendum for P5 on November 22, 2024. Corrective Action Ordered: Within 30 days of receiving this order, you must: · review and revise the support plan addendum for P2 to include how and when services are to be provided to P2; and · provide training to all staff that work with P2 on the updated support plan addendum and maintain documentation of this training in the personnel file including the date the training is completed, the number of hours per subject area, and the name of the trainer or instructor. On an ongoing basis, you must maintain compliance as required in this subdivision. 8. Citation: Minnesota Statutes, section 245D.071, subdivision 3. Violation: For one person whose record was reviewed (P4), the license holder did not complete initial intensive service planning as required. The license holder did not hold an initial planning meeting with P4, P4’s case manager, and other members of the support team or expanded support team within 45 days of service initiation to determine the following: · the scope of the services to be provided to support the person’s daily needs and activities; · P4’s preferences for how services and supports are provided, including how the provider will support P4 to have control of P4’s schedule; · opportunities to develop and maintain essential and life enriching skills, abilities, strengths, interests, and preferences; and · how technology might be used to meet P4’s desired outcomes. Corrective Action Ordered: Within 30 days of receiving this order, you must: · review and revise P4’s support plan addendum to include the information outlined above; · submit the updated support plan addendum to P4 and P4’s case manager for review and to obtain dated signatures documenting approval of the changes; and · train all staff that work with P4 on the updated support plan addendum and maintain documentation of this training in the personnel file, including the date the training is completed, the number of hours per subject area, and the name of the trainer or instructor. On an ongoing basis, you must maintain compliance as required in this subdivision. 9. Citation: Minnesota Statutes, section 245D.071, subdivision 4. Violation: For one person whose record was reviewed (P4), the license holder did not develop and document service outcomes and supports as required. The license holder did not document the supports and methods to be implemented to support P4 and accomplish outcomes related to acquiring, retaining, or improving skills and physical, mental, and emotional health and well-being including: · the methods or actions that would be used to support P4 and to accomplish service outcomes including techniques that were consistent with P4’s communication mode and learning style; and · the measurable and observable criteria for identifying when the desired outcomes had been achieved. Corrective Action Ordered: Within 30 days of receiving this order, you must: · develop and document the supports and methods outlined above and submit the revised plan to P4 and P4’s case manager for review and approval; and · train all staff that work with P4 on the updated plan and maintain documentation of this training in the personnel record including the date the training is completed, the number of hours per subject area, and the name of the trainer or instructor. On an ongoing basis, you must maintain compliance as required in this subdivision. 10. Citation: Minnesota Statutes, section 245D.071, subdivision 5. Violation: For one person whose record was reviewed (P4), the license holder did not provide a progress report as required. The license holder held a progress review meeting in September 2025. The license holder did not summarize P4’s status and progress toward achieving the identified outcomes and make recommendations and identify the rationale for changing, continuing, discontinuing implementation of the supports and methods in a report made available at the time of the progress review. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 11. Citation: Minnesota Statutes, section 245D.095, subdivision 3. Violation: For two persons whose records were reviewed (P1 and P5), the license holder did not maintain a service recipient record as required. The license holder did not maintain progress or daily log notes for P1 and P5. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. 12. Citation: Minnesota Statutes, section 245D.095, subdivision 4. Violation: For two persons whose records were reviewed (P2 and P6), the license holder did not ensure access to the service recipient record as required. The license holder did not ensure that staff providing services to P2 and P6 had access to the current support plan or portion of the plan assigned to the license holder and copies of the individual abuse prevention plan. Corrective Action Ordered: Within 30 days of receiving this order, you must ensure all staff providing services to P2 and P6 have access to the current support plan or portion of the plan assigned to you and copies of the individual abuse prevention plan. On an ongoing basis, you must maintain compliance as required in this subdivision. 13. Citation: Minnesota Statutes, section 245D.09, subdivision 4. Violation: For five of ten staff persons whose record was reviewed (SP1, SP2, SP4, SP5, and SP6), the license holder did not provide and ensure completion of orientation training as required. a. The license holder did not provide SP1, SP2, SP5, and SP6 with orientation to the service recipient rights and staff responsibilities related to ensuring the exercise and protection of those rights according to the requirements in section 245D.04. b. The license holder did not provide and ensure SP4 completed orientation in the following areas within 60 days of hire: · safe and correct use of manual restraint on an emergency basis according to the requirements in section 245D.061 or successor provisions, and what constitutes the use of restraints, time out, and seclusion, including chemical restraint; and · staff responsibilities related to prohibited procedures under section 245D.06, subdivision 5, or successor provisions, why such procedures are not effective for reducing or eliminating symptoms or undesired behavior, and why such procedures are not safe. The license holder hired SP4 on May 21, 2023, and SP4 received training on the above topics in May 2024. Corrective Action Ordered: Within 30 days of receiving this order, you must provide SP1, SP2, SP5, and SP6 with orientation to the service recipient rights and staff responsibilities related to ensuring the exercise and protection of those rights. Documentation of this orientation must be maintained in the personnel record, including the date the orientation is completed, the number of hours per subject area, and the name of the trainer or instructor. On an ongoing basis, you must maintain compliance as required in this subdivision. 14. Citation: Minnesota Statutes, section 245D.09, subdivision 5. Violation: For four persons whose records were reviewed (SP1, SP3, SP4, and SP6), the license holder did not provide annual training as required. Minnesota Statutes, section 245A.02, subdivision 2b defines “annual” or “annually” to mean prior to or within the same month of the subsequent calendar year. a. The license holder did not provide SP1 with annual training in the following areas in 2024 and 2025: · sections 245A.66, 626.557, and chapter 260E governing maltreatment reporting and service planning for children and staff responsibilities related to protecting children from maltreatment and reporting maltreatment. SP1 last received training on this topic in September 2023; and · the safe and correct use of manual restraint on an emergency basis according to the requirements in section 245D.061 or successor provisions, and what constitutes the use of restraints, time out, and seclusion, including chemical restraint. SP1 last received training on this topic in May 2023. b. The license holder did not provide SP3 with annual training in the following areas in 2025: · section 245A.66 and chapter 260E governing maltreatment reporting and service planning for children and staff responsibilities related to protecting persons from maltreatment and reporting maltreatment; · the principles of person-centered service planning and delivery as identified in section 245D.07, subdivision 1a, and how they apply to direct support service provided by the staff person; · the safe and correct use of manual restraint on an emergency basis according to the requirements in section 245D.061 or successor provisions, and what constitutes the use of restraints, time out, and seclusion, including chemical restraint; and · staff responsibilities related to prohibited procedures under section 245D.06, subdivision 5, or successor provisions, why such procedures are not effective for reducing or eliminating symptoms or undesired behavior, and why such procedures are not safe. SP3 last received training on these topics in February 2024. c. The license holder did not provide SP4 with annual training on the service recipient rights and staff responsibilities related to ensuring the exercise and protection of those rights according to the requirements in section 245D.04 in 2024 and 2025. SP4 last received training on this topic in May 2023. d. The license holder did not provide SP6 with annual training on the principles of person-centered service planning and delivery as identified in section 245D.07, subdivision 1a, and how they apply to direct support service provided by the staff person in 2024 and 2025. SP6 last received training on this topic in August 2023. Corrective Action Ordered: Within 30 days of receiving this order, you must: · provide SP1 with training on the topics outlined in (a); · provide SP3 with training on the topics outlined in (b); · provide SP4 with training on the service recipient rights and staff responsibilities related to ensuring the exercise and protection of those rights; · provide SP6 with training on the principles of person-centered service planning and delivery and how they apply to direct support service provided by the staff person; and · maintain documentation of these trainings in the personnel record including the date the training is completed, the number of hours per subject area, and the name of the trainer or instructor. On an ongoing basis, you must maintain compliance as required in this subdivision. 15. Citation: Minnesota Statutes, section 245D.095, subdivision 5. Violation: For three staff persons whose records were reviewed (SP2, SP4, and SP6), the license holder did not maintain a personnel record as required. The license holder did not maintain a personnel record for SP2, SP4, and SP6 that included documentation of staff training, including the date the training was completed, the number of hours per subject area, and the name of the trainer or instructor. Corrective Action Ordered: On an ongoing basis, you must maintain compliance as required in this subdivision. If you fail to correct the violations specified in the Correction Order within the prescribed time lines the Commissioner may issue an Order of Conditional License or may impose a fine and order other licensing sanctions pursuant to Minnesota Statutes, sections 245A.06 and 245A.07. Submissions required as part of a corrective action ordered must be sent to your Licensor at: 1. By secure email at erin.white1@state.mn.us; or 2. If you are unable to submit corrective action ordered securely through email, you can mail or fax using the information below: Commissioner, Department of Human Services ATTN: Erin White Licensing Division PO Box 64242 St. Paul, MN 55164-0242 B. Right to Request Reconsideration If you believe any of the citations are in error, you have the right to request that the Commissioner of Human Services reconsider the parts of the Correction Order that you believe to be in error. The request for reconsideration must be in writing and received by the Commissioner within 20 calendar days after receipt of this report. Your request for reconsideration must be sent to: Commissioner, Department of Human Services ATTN: Legal Unit Licensing Division PO Box 64242 St. Paul, MN 55164-0242 Please note that a request for reconsideration does not stay any provisions or requirements of the Correction Order. The Commissioner’s disposition of a request for reconsideration is final and not subject to appeal under Minnesota Statutes, chapter 14. If you have any questions regarding this Correction Order, please contact me as soon as possible. Erin White, Home and Community Based Services Licensor Licensing Division Office of Inspector General 651-431-4821
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